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The aim of this study was to investigate the reproductive profiles, metabolic parameters and cardiometabolic risk assessed by surrogate indexes in women with adenomyosis. Ninety-six premenopausal women who were diagnosed with adenomyosis by transvaginal ultrasound and 97 age-body mass index (BMI) matched controls with normal ultrasound during routine examination were included. Women with adenomyosis were more likely to have higher gravidity and had more abortions than women without adenomyosis. Regarding the individual metabolic syndrome components, the adenomyosis group was more likely to have higher prevalence of hypertension, low HDL-C and central obesity. No significant difference was found between the groups in terms of visceral adiposity index, lipid accumulation product and fatty liver index. Only higher blood pressure (BP) remained statistically significant after adjustment for confounding factors in multivariate analysis. Women with adenomyosis had remarkably high risk of hypertension. It may be advisable to monitor their BP closely.Impact Statement What is already known on this subject? The only anthropometric characteristic assessed in women in relation to adenomyosis is body mass index (BMI). A case-control study showed that women who are obese are more likely to have adenomyosis. The gravidity, number of spontaneous abortions and previous uterine surgeries such as dilatation and curettage (D&C) and caesarean section were found significantly associated with adenomyosis. What do the results of this study add? A remarkable finding of our study was the increased incidence of higher systolic BP in women with adenomyosis. No difference was observed in adiposity indices between women with and without adenomyosis. Higher prevalence of central obesity and lower HDL-C levels were seen in women with adenomyosis. What are the implications of these findings for clinical practice and/or further research? The study identifies that adenomyosis is associated with an increased risk of hypertension, and women with adenomyosis may be monitored closely for blood pressure changes. Our report also provides novel information about the metabolic risk profiles associated with adenomyosis.

Purpose- Multiple transformations have begun with the shift from industry-oriented to information-oriented structures in the free zones. The study aims to examine the dilemmas and difficulties observed in the transformation of free zones operating in Turkey. Methodology- The study is in quantitative design. The study used the trade volume data according to the countries realized by the free zones in Turkey in 2020. Findings- While the analysis reveals the global trade of free zones, it also reveals results of the ratio of exports to imports of 17 free zones. Conclusion- The results highlight the need for these regions to be integrated into high-tech industrial transformation policies. Keywords: Free zones, transformation, global trade, Turkey, trade volume. JEL Codes: F10, F14, M16

Aim:To assess the risk factors associated with high rate of insufficient endometrial sampling on endometrial biopsy in postmenopausal women.Methods:Data were retrieved from the records of 522 consecutive patients who underwent endometrial sampling. Logistic regression analyses were performed to determine various factors associated with scanty endometrial biopsy. The exclusion criteria included patient refusal, uncertain menopausal status, cervical carcinoma detected after sampling and unavailable records.Results:The sample was insufficient for a definitive diagnosis in 143 (25.9%) patients. Out of these, 53 cases were investigated with invasive procedures. Further histopathological examination revealed that five (9.4%) patients had uterine malignancy. Based on the multivariate analysis, time since the onset of menopause [Odds ratio (OR)=1.044, 95% confidence interval (CI)=1.000-1.090, p=0.049] was significantly associated with insufficient endometrial biopsy in cases with a endometrial thickness of >12 mm on ultrasonography (OR=0.624, 95% CI=0.472-0.824, p=0.001). The use of dilation and curettage technique (OR=0.662, 95% CI=0.522-0.841, p=0.001) decreased the risk of insufficient sampling on endometrial biopsy.Conclusion:Time since the onset of menopause and the thickness of endometrium were significant independent factors associated with insufficient sample. Using Karman cannula for endometrial aspiration may not be a reliable method in the evaluation of postmenopausal women. An insufficient endometrial sample does not rule out endometrial carcinoma, therefore, a further histopathological examination is recommended.

Objective: We aimed to determine the frequency of endometrial pathologies of patients who presented to our outpatient clinic with postmenopausal bleeding (PMB) and asymptomatic menopausal patients with a finding of thickened endometrium on transvaginal ultrasonography.Study Design: This study was performed at Bezmialem University Hospital. Women who presented to our clinic from January 2015 to January 2017 were analyzed. Patients were divided to two groups. All patients underwent transvaginal ultrasound with a 7.5 MHz probe. Endometrial sampling was performed by either blind D&C (dilatation & curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.Results: Electronic records of a total of 368 patients in menopause were inspected. Out of these patients; 287 (78%) underwent endometrium sampling indicated by bleeding. Eighty-one patients (22%) were asymptomatic; however, a thickened endometrium echo on TVUSG examination (≥ 5 mm) was suspected. The median age was 57 (42-85). In both groups the two leading causes of endometrial pathology was; endometrial polyps followed by proliferative endometrium. The frequency of endometrial cancer was 9.4 % for the PMB group and 1.2 % in the asymptomatic patient groupConclusion: Evaluation of PMB as soon as possible is essential for diagnosing endometrial pathologies. Role of endometrial thickness is decisive in detecting patients at high risk for malignancy especially with comorbid conditions. Histopathological evaluation is mandatory for ruling out malignancy.

Aim: The aim of this study was evaluating the effectiveness of vitamin D in the treatment of primary dysmenorrhea.Material and Methods: A total of 142 patients between 16 and 35 years of age who were admitted to a university hospital and diagnosed with primary dysmenorrhea were included in the study in a randomized controlled manner. Cases were randomized into three groups of 667 IU vitamin D once a day, 200 IU vitamin E once a day and 400 mg ibuprofen twice a day. The treatment was given two days before the expected date of menstruation and the first three days of menstruation. Treatment was continued in two consecutive cycles. Severity of menstrual pain was measured with Visual Analogue Scale (VAS), as the primary outcome. Need for using nonsteroidal anti-inflammatory drugs (NSAIDs) during two-month study period was evaluated as the secondary outcome.Results: There were no significant difference in age, body mass index and baseline VAS scores between groups. Pain severity of vitamin D group after treatment was found as low as in the ibuprofen group. Median VAS scores of vitamin D, vitamin E and ibuprofen groups were 5 (1-10), 7 (1-10) and 7 (2-10), respectively after treatment (p

Objective: We aimed to estimate the prevalence of microscopic hematuria in women with pelvic organ descent and compare the results in terms of severity and accompanying urinary symptoms. We hypothesized that microhematuria incidence would be higher in advanced prolapse and accompanying urinary symptoms.Study Design: Women who presented to our clinic from January 2013 to July 2016 were analyzed using our electronic medical record system. Those who were classified in the system under the "N81: female genital prolapse" code were included. Records were checked to certify that samples were acquired properly. Urogynecological examinations were performed by specialist gynecologists and documented according to the international continence society classification system. After ruling out urinary tract infections urinalysis was performed by an integrated system composed of an urine strip analyzer and a sediment autoanalyzer.Results: Gravidity, parity, menopause onset, smoking status and presence of systemic disease were similar for both groups. Women in the hematuria group were older (p

Objective Vaginally assisted laparoscopic sacrocolpopexy (VALS), which is a combined surgical approach where a vaginal hysterectomy is initially performed, followed by transvaginal placement of synthetic mesh and laparoscopic suspension, can be an alternative to overcome the dissection, suturing limitations of laparoscopic sacrocolpopexy. The aim of this study was to compare the operative times and middle-term anatomic outcomes of women with uterovaginal prolapse undergoing VALS with those of women undergoing abdominal sacrocolpopexy. Methods This is a prospective cohort study that evaluates operation times, anesthesia times, estimated blood loss, middle-term outcomes, perioperative and postoperative complications. We compared the results of 47 women who had the VALS to that of 32 abdominal sacrocolpopexy (AS). Results The mean follow up was 22.4 months for AS group and 20.5 months for VALS group. The VALS group (median 1 day) had shorter hospitalization duration than the AS group (median 3 days). The mean operation time was significantly shorter in the VALS group (125.9 minutes) than the AS group (151.9 minutes) (P = .03). There was no significant difference in perioperative and postoperative complication rates. Objective failure rate (8.5% in VALS, 15.6% in AS), subjective failure rates (6.4% in VALS, 9.4% in AS), recurrence (2.1% in VALS, 9.4% in AS) and mesh exposition rates (2.1% in VALS, 9.4% in AS) were similar in both procedures. Conclusions VALS with shorter operative time and hospitalization than conventional AS is a promising modification minimally invasive technique for sacrocolpopexy especially for those inexperienced in laparoscopic sacrocolpopexy.

Objective: Intra-abdominal pressure (IAP) was defined as the steady state pressure concealed within the abdominal cavity. Sustained increased in IAP has become the focus of attention in many disciplines which is has impact on pulmonary, cardiovascular systems. Pelvic organ prolapse might be the consequences of compensation of abdominal compliance to increased IAP. The aim of this study was to evaluate the effect of laparoscopic sacrocolpopexy in patients with severe uterovaginal prolapse on intraabdominal presurre. Design: Prospective, case control study Setting: Tertiary Urogynecology Unit Population: Women with advanced symptomatic stage ≥3 uterovaginal prolapse. Method: IAPs were measured in 13 women, before and 6 month after laparoscopic sacrocolpopexy and in 13 controls. Main Outcome Measure: Preoperative and postoperative IAP. Results: The mean preoperative IAP of controls (4.5 ± 1 mmHg) was not significantly different than to women with stage ≥3 uterovaginal prolapse (p=0.1). The mean postoperative IAP at 6 months control was 8.6 ±2.5 mmHg and significantly higher than postprocedure IAP of control group (4.8 ± 1.1 mmHg) (p

Introduction:Our objective was to compare the effect of rectal misoprostol (Cytotec) versus rectal hyoscine-n-butyl bromide (Buscopan) on patients undergoing hysteroscopy. We hypothesised that HBB may have a role in cervical priming. Material and methods:This trial was conducted at Bezmialem Vakif University Hospital. Women of reproductive age between 18-50 years who were scheduled for operative hysteroscopy indicated by type 1 submucous myoma or endometrial polyps were recruited for the study. Ninety patients were divided randomly into three groups. Group 1 received placebo treatment. Group 2 received rectal 200 mcg misoprostol and Group 3 received rectal 20 mg hyoscine-n-butyl bromide two hours before the procedure. Procedures were performed using a bipolar 26 F (9 mm) continuous-flow rigid resectoscope with a 30 degrees lens. The outcome measures included cervical dilation width and time, ease of cervical dilation, procedure time and operative complications. Postoperative self-rated pain was assessed one hour after the procedure. Results:Thirteen patients (43. 3%) in the placebo treatment group, 11 patients (36.7%) in the misoprostol group and four patients (13.3%) in the hyoscine-n-butyl bromide group needed analgesics postoperatively (p = .02). The mean duration of cervical dilation time was longest in Group 1 and shortest in Group 3, however this difference did not reach statistical significance (p=.11). There was no difference with regard to other studied parameters. Summary:HBB reduced the need for pain medication compared to placebo. Larger studies are needed to further investigate the role of HBB in facilitating pre-operative cervical priming.

Maintaining of precise balance between oxidation and anti-oxidation is important in both physiological and pathological states. Knowledge about this balance may give an idea about the process of the disease. The aim of this study was to investigate dynamic thiol-disulfide homeostasis in patients with low-grade gliomas.Serial serum samples were collected in 13 patients operated on low-grade gliomas before and after surgery. Control serum samples were obtained from venous cord blood from 13 healthy women during cesarean section. Total thiol, native thiol, and disulfide bond formation were measured and compared with the controls.Total thiols, native thiols, and disulfide bond formation were significantly elevated in patients before the surgery compared to the controls (p0.05). Even after the surgery, these three parameters were still high in patients, and the differences were significant (p0.05). Although no significant difference was found between patients and controls regarding the ratios of disulfide/total thiol, disulfide/native thiol, and native thiol/total thiol (p0.05), the balance seemed to shift to oxidative side.Thiol-disulfide homeostasis was disrupted in patients with low-grade gliomas, and oxidation may play a role in the process of this disease. Supplementation with antioxidants before and after surgery may be taken into consideration.

Objective: The main purpose of our study is to categorize starting doses of recombinant follicle-stimulating hormone (recFSH) based on various cutoff values of anti-Mullerian hormone (AMH) and to determine the effectiveness of serum AMH levels in the prediction of poor ovarian response. Material and methods: Prospective data analysis was conducted at IVF center. A total of 323 patients were included. All patients were divided into four groups according to the patients’ serum AMH concentrations: Group 1 (AMH < 1 ng/ml; 450 IU/day n = 157); Group 2 (AMH 1–2 ng/ml; 375 IU/day, n = 55); Group 3 (AMH 2–3 ng/ml; 225 IU/day, n = 48); and Group 4 (AMH > 3 ng/ml; 150 IU/day, n = 63). Collected data included age, total gonadotropin dosage, duration of stimulations, the total number of oocytes retrieved, ovarian response, cancelation rate, and cPRs. Results: As serum AMH levels increased, there were significant decreases in the starting recFSH dose and total gonadotropin dosage, and a significant increase in the total number of oocytes retrieved. There was a significant trend toward increasing cycle cancelation rates and decreasing cPRs with decreasing serum AMH levels. Although there were no significant differences with regard to the proportion of cycles with hypo-response between all groups. A result of ?0.83 was considered the cutoff value of AMH to predict a hypo-response to ovarian stimulation. Conclusions: AMH is a useful marker in selecting the starting dose of recFSH and prediction of poor ovarian response. Our protocol may allow clinicians to modulate the starting dose of recFSH according to these cutoff values for serum AMH levels. © 2017 Informa UK Limited, trading as Taylor & Francis Group.

OBJECTIVE The aim of this study is to investigate the association of sexual functions with levator hiatus biometry measurements and levator ani muscle defect. METHODS In 62 heterosexual, sexually active premenopausal women without pelvic floor disorders or urinary incontinence, 3-dimensional transperineal ultrasound imaging was used. Two 3-dimensional volumes were recorded, one at rest and one on Valsalva maneuver. Levator biometry measurements and levator defect were evaluated in an axial plane. Sexual function was assessed by a validated questionnaire, Female Sexual Function Index (FSFI). The primary outcome measure was correlation of sexual functions with the levator hiatus area, transverse and anteroposterior diameters, levator ani muscle thickness, vaginal length, and changes in measurements with Valsalva and levator defect. RESULTS Forty-two women (67.7%) had low total FSFI scores (

Aim: The aim of the study was to evaluate the surgical indications, routes of surgery and the correlation between preoperative diagnosis and histopathological examination of hysterectomy specimens. Material and Method: Medical records and histopathological findings were reviewed and analyzed retrospectively, in 422 consecutive women who underwent hysterectomy over a two-year period from 2011 to 2014. Those with confirmed malignancy before operation were excluded. Cohen kappa statistics were used to measure agreement between preoperative clinical and postoperative histopathological diagnosis which was found to be fair with %u043A value being 0.4. Results: The mean age of our patients was 51.5 ± 8 years. The abdominal route was used in 378 cases (85.5%), the vaginal route in 55 patients (12.4%) and the laparoscopic-assisted vaginal hysterectomy in 9 cases (2%). Abnormal uterine bleeding (28.9 %) was the most common indication for hysterectomy. The histopathology of the endometrium prior to hysterectomy was reported in 75% of the cases and the most common finding was a secretory or proliferative endometrium. Leiomyomatous uterus was the most frequently encountered pathology (43.7%) followed by coexistence of leiomyoma and adenomyosis (17.4%) in hysterectomy specimens. Hysterectomy specimens may be unremarkable histopathologically, most of which are vaginal hysterectomies done for uterine prolapsed (kappa=0,407). Discussion: The correlation between the preoperative clinical and the pathological diagnosis were poor in cases with abdominal pain, abnormal uterine bleeding and fibroids. But there was a high correlation in cases with adnexial mass.

The diagnosis of premature ovarian failure is traumatic to women, with loss of gonadal functions having been associated with distress and anxiety. The aim of this study is to evaluate the sexual function and distress of women with premature ovarian failure before the diagnosis. Women with premature ovarian failure and age-matched controls were evaluated through the Female Sexual Function Index and the Female Sexual Distress Scale-Revised, and their androgen levels were compared. The major finding of this study is the lack of difference between sexual function in women who are unaware that they have premature ovarian failure and age-matched women with normal gonadal function.

Aim The objective of the analysis was to determine the characteristics that distinguish women with adenomyosis and leiomyomas from those with leiomyoma only from a sample who underwent hysterectomy for benign uterine diseases. Methods This retrospective study was based on the analysis of medical records of 75 women with both adenomyosis and uterine leiomyomas and 218 women with leiomyomas only, diagnosed by histologic analysis of uterine specimens. Results Results of multivariate logistic regression analyses showed that women with both adenomyosis and leiomyomas had a higher gravity (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.01–1.33) and more frequent pelvic pain (OR 0.38, 95% CI 0.21–0.7) compared with women with leiomyomas only. Postmenopausal bleeding was commonly reported in women with adenomyosis and leiomyomas. No significant difference was observed between the two groups in terms of menorrhagia and metrorrhagia and the preoperative diagnosis of prolapse. Conclusions The presence of concomitant adenomyosis may cause different clinical symptomatology.

The aim of this study was to investigate the clinical, endocrine, metabolic features and prevalence of metabolic syndrome (MBS) in Turkish adolescents with polycystic ovary syndrome (PCOS) and the differences in metabolic parameters between adolescent PCOS with or without the presence of polycystic ovaries (PCO) on ultrasound. Subjects (n = 77) were classified into two groups: oligomenorrhea (O) and clinical and/or biochemical hyperandrogenism (HA) (n = 38), without PCO and O + HA with PCO (n = 39). The control group consisted of 33 age-matched adolescents. Adolescents with PCOS had a significantly higher body mass index (BMI), waist circumference and levels of LH, LH/FSH ratio, triglyceride, insulin, HOMA-IR, free androgen index and lower levels of SHBG and FSH. After adjustment for BMI, LH, LH: FSH ratio remained significantly higher. Adolescents with PCOS had a higher prevalence of MBS. No significant differences in lipid profiles, insulin levels and insulin sensitivity in both the PCOS groups were seen. HDL-C levels were lower in the O + HA + PCO group compared to the controls. BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS. Impact statement Many studies have investigated the effect of PCOS on metabolic and cardiovascular risks. It is thought that PCOS increases metabolic and cardiovascular risks. Increase in metabolic and cardiovascular risks associated with PCOS may be handled with early diagnosis and early intervention of PCOS in adolescents, although the diagnosis of PCOS in adolescents could be hard because of the features of PCOS overlapping normal pubertal physiological events. However, early identification of adolescent girls with PCOS may provide opportunities for prevention of well-known health risks associated with this syndrome and reduction of long-term health consequences of PCOS by reducing androgen levels and improving metabolic profile. Our results also support that BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS.

WOS: 000369949900011 PubMed ID: 26182187 Purpose: We aimed to investigate the association of metabolic syndrome and metabolic risk factors with endometrial hyperplasia and carcinoma among women with abnormal uterine bleeding (AUB). Methods: This study included 199 patients who had undergone endometrial curettage due to abnormal uterine bleeding. We divided the patients into two groups according to whether they had an abnormal (n = 53) or normal endometrium (n = 146). Waist circumference, blood pressure, fasting glucose and serum lipid levels were measured and statistically analyzed. The women in each group were matched with regard to mean age, gravidity, parity and menopausal status. Results: We found increased prevalence of metabolic syndrome, diabetes, general and abdominal obesity, hypertension, elevated levels of glucose, total cholesterol and LDL-cholesterol and reduced levels of HDL-cholesterol among women with endometrial carcinoma and hyperplasia. These results were detected particularly in postmenopausal (450 years) women compared to pre-menopausal cases (550 years). All metabolic parameters were similar between hyperplasia and cancer groups. Conclusion: Metabolic syndrome and its components have been shown to have profound impacts on initiation and progession of endometrial pathology, particularly during postmenopausal period.

To determine which type of blunt expansion of a low transverse uterine incision during operative delivery is associated with decreased blood loss and intra- and post-operative morbidity for a caesarean section (CS).The prospective randomised-controlled trial was conducted at the Department of Obstetrics and Gynecology, Bezmialem University Hospital. The patients were randomly assigned to a group that received a cephalad-caudad (n = 55) or transverse (n = 57) blunt expansion of the low transverse uterine incision. Intra- and post-operative morbidity at caesarean delivery in short-term including blood loss, operating time, post-operative pain with the faces pain rating scale, and post-operative morbidity were analysed.The changes in both haemoglobin (p 0.01) and haematocrit (p 0.01) from the pre-operative to post-operative values, estimates of blood loss (p 0.01) were significantly lower in cephalad-caudad group and the post-operative haematocrit concentrations (p = 0.02) were significantly greater in cephalad-caudad group when compared with the transverse group. The damage of parametrial and uterine vessels into lateral edges were recorded in 11 (19.6%) patients in transverse group and 7 (12.9%) patients in cephalad-caudad group and there is no statistical significance between groups in terms of these parameters (p 0.05, 95% CI 0.19, 1.63).Our findings suggest that cephalad-caudad blunt expansion of the low transverse uterine incision decreases blood loss compared to transverse blunt dissection.

Peritonization of mesh during sacrohysteropexy is generally advocated to prevent adhesions to the viscera; however, randomized clinical trials are lacking, and peritonization may not be completely possible in a laparoscopic hysteropexy procedure. Our main objective was to describe a basic experimental rat sacrohysteropexy model. We hypothesized that even when peritoneal closure was omitted, using composite mesh would result in less adhesions to the viscera. Twenty in-bred female virgin Wistar Hannover rats were used in this study. Standardized hysteropexy procedure and adhesion model is described step by step with two different mesh materials: polypropylene and a composite polyester. Mesh was anchored between the posterior cervix and anterior longitudinal ligament of the lumbar vertebrae. Macroscopic adhesion scores and histopathological tissue reaction was investigated. Macroscopically, the surface area involved in adhesions was similar between groups. However, adhesions in the polypropylene group were more dense, required sharp dissection for lysis, and yielded higher total macroscopic adhesion scores (p

Dental hygienic habits should be maintained in pregnancy despite challenges. We aimed to study the dental attitudes and habits of pregnant women. The patients attending our hospital clinic were invited to fill out a structured questionnaire categorised into three major domains: (1) general oral hygiene status, (2) dental habits, and (3) dental attandence both during pregnancy and prior to pregnancy. Four hundred and seventy four women agreed to participate. Mean age of participants was 28 (18-43). While 184 (38%) women reported brushing twice a day, only 98 (20%) women claimed using floss and or mouth rinse. Fifty-nine (12.4%) women had a dental visit in their current pregnancy and 24 (5.1%) received professional treatment. Obstetric care givers should convey the importance of dental care to their patients. We suggest that dental health should be improved antenatally, and be assessed in detail by dental health care providers. Impact Statement Poor oral health conditions have shown to be associated with an increased risk of adverse pregnancy outcomes, especially in low-income countries and regions. There is escalating evidence to support the lack of awareness among pregnant women about health consequences and long term risks associated with poor oral hygiene. Our results showed that dental hygienic practices of pregnant women are disconcerting in Turkey. The need for inter-professional collaboration among obstetric healthcare providers and dental specialistis is crucial for conveying to women the importance of dental care in pregnancy and beyond.

Aim: To investigate whether maternal serum levels of 25-hydroxyvitamin D [25(OH)D] in the first trimester is associated with an increased risk of gestational diabetes mellitus (GDM). Methods: We conducted a cross-sectional study of a cohort of pregnant women who had undergone routine genetic multiple marker screening and subsequent glucose tolerance testing. Twenty-five women with GDM and 208 controls without GDM were included in this study. Plasma 25(OH)D concentrations were measured using liquid chromatography-tandem mass spectrometry. Results: Mean 25(OH)D concentrations at 11-14 weeks of gestation were not significantly different in women who subsequently developed GDM compared with those who did not (mean ± standard deviation: 13.96 9.05 versus 13.43±9.72; p=0.8). The prevalence of first-trimester severe 25(OH)D deficiency (

Airway changes, difficult ventilation, and intubation are the leading causes of morbidity and mortality in pregnancy, but no prospective study has evaluated the relationship between airway changes and brain natriuretic peptide (BNP) before and after cesarean section operations. The purpose of this study was to evaluate the relationship between BNP and airway changes in women undergoing delivery and during the postoperative period.Included in this prospective study were a total of 35 pregnant females with ASA I physical status who were scheduled for cesarean section under general anesthesia. BNP levels, Mallampati classification, mouth opening, thyromental distance, sternomental distance, and the degree of neck extension were recorded before cesarean section and 24 h after the operation. Laryngeal views were also documented after intubation.Significant differences in BNP levels, Mallampati classification, mouth opening, thyromental distance, sternomental distance, and the degree of neck extension measurements arose between initial measurements and those measurements made 24 h postoperatively. Pre-delivery Mallampati I, II, III, IV scores of 6, 18, 7, 4 had by 24 h after cesarean section changed to 13, 13, 6, 3, respectively (p0.05). Initial BNP levels were 7.59 ± 6.30; postoperative levels were 52.39 ± 48.17. In this study we found a correlation between perioperative BNP levels and difficult intubation parameters.Within 24 h postpartum, Mallampati scores changed in 13 patients (30.95 %). Besides the correlation between BNP levels and difficult intubation parameters, we also found significant differences in initial and postoperative BNP values.

Ozbar, Nurper/0000-0003-0931-5263; OZBAR, NURPER/0000-0003-0931-5263 WOS: 000342894800024 PubMed: 24852255 Ozbar, N, Ates, S, and Agopyan, A. The effect of 8-week plyometric training on leg power, jump and sprint performance in female soccer players. J Strength Cond Res 28(10): 2888-2894, 2014The aim of this study was to determine the effect of 8-week plyometric training (PT) on the leg power and jump and sprint performance in female soccer players. Eighteen female soccer players from Women Second League (age = 18.2 +/- 2.3 years, height = 161.3 +/- 5.4 cm, body mass = 56.6 +/- 7.2 kg) were randomly assigned to control (n = 9) and plyometric (n = 9) groups. Both groups continued together with regular technical and tactical soccer training for 4 days a week. Additionally, the plyometric group underwent PT for 8 weeks, 1 day per week, 60-minute session duration. During the 8-week period, the control group was hindered from any additional conditioning training. All players' jumps (triple hop, countermovement jump, and standing broad jump), running speed (20 m), and peak power were evaluated before and after 8 weeks. No significant difference was found between the groups at pretest variables (p > 0.05). Significant improvements were found in the posttest of both the groups (p 0.05), except for 20-m sprint test in the control group (p > 0.05). Triple hop distance, countermovement jump, standing broad jump, peak power, and 20-m sprint test values were all significantly improved in the plyometric group, compared with the control group (p 0.05). We concluded that short duration PT is an improved important component of athletic performance in female soccer players. The results indicate that safe, effective, and alternative PT can be useful to strength and conditioning coaches, especially during competition season where less time is available for training.

Purpose: To compare the pregnancy outcomes and the route of delivery in women who have had recurrent spontaneous abortions with primigravid and multigravid women without a history of spontaneous abortion. Materials and methods: This study included 40 women with a history of recurrent spontaneous abortions and 107 women as the control group who gave birth at Suleymaniye Obstetrics and Gynecology Hospital between 2003 and 2007. The control group was divided into two subgroups: 57 primiravid women and 50 multigravid women. Data were collected from hospital records retrospectively. Results: Pregnant women with previous recurrent miscarriages have significantly higher rates of threatened abortion than primigravid and multigravid women (p 0.05). Conclusion: In conclusion we found that pregnancies after recurrent pregnancy losses were not related with adverse perinatal outcomes although they had high cesarean rates. Pam Med J 2014;7(1):41-45

Gonderilme tarihi: 05.04.2013 Kabul tarihi: 30.07.2013 Abstract Purpose: To evaluate the effect of manual strangulation of the uterine isthmus on the amount of blood loss during elective cesarean section. Materials and methods: Participants with indication of elective cesarean section were randomly allocated to two groups. In Group 1 (71 women), manual strangulation of the uterine isthmus right after the removal of the placenta was applied, whereas no such technique was applied in Group 2 (66 women). Both groups then were compared in terms of haematocrit change on the first postoperative day. Results:No demographic difference was observed between groups. The mean difference between the preoperative and postoperative 24 h haematocrit values was significantly lower in Group 1 (3.05±2.57) compared to the group 2 (4.35±2.38; p

Objective: The aim of this study is detection of optimal sperm parameters by evaluating the effects of motile sperm count and morphology on clinical pregnancy rates in patients who applied for intrauterine insemination. Methods: This study comprised 279 intrauterine insemination cycles, which has applied to 172 infertile patients between January 2003 and June 2005, in Süleymaniye Obstetrics-Gynecology Hospital, Infertility Unit. We, firstly compared the clinical pregnancy rates according to processed total progressive motile sperm count, by classifying IUI cycles into two groups as, Amaç: Bu çalışmanın amacı intrauterin inseminasyon uygulanan hastalarda hareketli sperm sayısı ve morfolojinin gebelik oranlarına etkisinin değerlendirilip optimal sperm parametrelerinin tespitidir. Yöntemler: Ocak 2003 ve Haziran 2005 tarihleri arasında Süleymaniye Kadın Hastalıkları ve Doğum Eğitim ve Araştırma Hastanesi, Tüp Bebek Kliniği\'nde 172 infertil hastaya uygulanan 279 intrauterin inseminasyon siklüsünü içeren bir çalışmadır. Intrauterin inseminasyon (IUI) siklüslerini ilk önce hazırlama sonrası TPMSS\'na göre

To examine the effect of ranibizumab on surgically induced endometriosis in rat models.Endometrial tissue was implanted onto the abdominal peritoneum of 20 rats that were randomized into 2 groups. The rats in group 1 (n = 9) were given 0.6 mg/kg ranibizumab on the 1st and 14th days after the second operation. The rats in group 2 (control group, n = 9) received no medication. All the rats were observed for a total of 28 days.At the end of the treatment, the mean volume and weight of the explants in group 1 (11.49 ± 6.87 mm(3) and 36.61 ± 17.84 mg) were significantly lower than that of the control group (190.6 ± 177.4 mm(3) and 187.3 ± 174.5 mg; both Ps.01). Mean epithelial histologic scores were significantly lower in group 1 (1.11 ± 0.78) than that of the control group (2.33 ± 0.71; P.01). When compared with the control group, vascular endothelial growth factor (VEGF) immunoreactivities in group 1 showed statistically significant reductions (1.67 ± 0.50; 2.67 ± 0.50; P.01).Ranibizumab has significantly regressed the size of the endometriotic implants and caused atrophy of these lesions in rats by decreasing explant levels of VEGF.

The goal of this study is to compare the prevalence and clinical outcomes of a one-step with a two-step screening method, both of which are commonly used for the diagnosis of gestational diabetes mellitus (GDM).Women who presented for GDM screening and who consented to participate in this study were randomized into two groups. The women in Group 1 (n = 386) were screened using a one-step method (2-h, 75 g oral glucose tolerance test (OGTT)) and in Group 2 (n = 400) by a two-step method (the 50 g glucose challenge test (GCT) followed by the 100 g OGTT). The pregnancies were then classified into three subgroups as follows: women who had negative 2-h 75 g OGTT results according to IADPSG criteria (IADPSG-negative), women with negative 50 g GCT results (GCT-negative) and women with positive 50 g GCT results but negative 3-h 100 g OGTT results according to CC criteria (CC-negative).The prevalence of GDM using the one-step and two-step methods was 14.5% and 6%, respectively. In adjusted multivariable regression models, women in the GCT-negative and the CC-negative groups had greater risk of polyhydramnios than women in the IADPSG-negative group [adjusted prevalence risk ratios (aPR), 1.40; 95% confidence intervals (CI), 1.03-1.91; aPR, 2.76; 95% CI, 1.27-6.02, respectively]. Women in the CC-negative group had greater risk of pre-eclampsia than women in the IADPSG-negative group (aPR, 3.30; 95% CI, 1.57-6.91).Women who were defined as having normal glucose tolerance by IADPSG had better perinatal outcomes than women who were defined as having normal glucose tolerance by GCT and women who were GCT-positive with a negative OGTT.

Gonderilme tarihi: 07.04.2013 Kabul tarihi: 18.07.2013 Abstract Purpose: To evaluate the utility of initial fasting plasma glucose (FPG) to limit the number of oral glucose tolerance test (OGTT)s needed for the diagnosis of gestational diabetes mellitus (GDM). Materials and methods: 390 pregnant women (estimated gestational ages 24–28 weeks) were evaluated for GDM using OGTT based on International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Two FPG thresholds (of the OGTT) were used to rule in and to rule out GDM. Results: Using IADPSG criteria, 61 (15.6%) of the participants had GDM. The area the under ROC curve of FPG used to detect GDM was 0.933. An FPG cut-off value of ≥5.1mmol/l had sensitivity of 70.49% and specificity of 100.00% in diagnosing GDM. An FPG cut-off value of ≤4.5 mmol/l had sensitivity of 93.44% and specificity of 67.6% in diagnosing GDM. Undergoing an initial FPG could have saved 67.7% of these women from taking the OGTT and only 1.5% (4 of the 264) would have been misclassified. Conclusion: Screening using an initial FPG rule-in and rule-out algorithm reduces the number of OGTTs needed for the diagnosis of GDM. Almost all GDM pregnancies can be diagnosed.

WOS: 000388776000028 PubMed ID: 27693938 Objective: To investigate the effect of a previous IVF failure on the quality of life and emotional distress, in couples undergoing IVF treatment. Experiencing IVF failure might cause differences on the anxiety depression and quality of life scores of the couples, compared to the ones who were undergoing IVF treatment for the first time. Study design: This study included 64 couples who had previously experienced at least one IVF failure (Group 1) and 56 couples without history of IVF failure (Group 2) in a private Assisted Reproductive Center, Istanbul, Turkey. A sociodemographic data form, the FertiQoL International and Hospital Anxiety (HAD-A) and Depression scale (HAD-D) for evaluating the status of distress, were administered for the study. Result(s): FertiQoL scores were compared between the groups, the environment scale of the quality of life in treatment section was found to be significantly higher in Group 1 compared with Group 2 (p = 0.009). The HAD-A and HAD-D scores did not differ significantly between the groups. Group-variables were investigated using multilevel analysis, the infertility duration and income level were found to have an effect on the subscales of quality of life (p = 0.009 and p = 0.001 respectively) in Group 2. Depression scores were higher in couples with infertility duration of below five years in Group 1 and Group 2 compared to couples with infertility duration of five years or above (MANOVA analysis). The level of education was found to affect the scores of HAD-D in Group 2, but not in Group 1 (p = 0.011). The score of HAD-D was significantly affected by the family type only in Group 2 (p = 0.009); the depression score of the couples living with a nuclear family was found to be higher compared with the couples living in a traditional family (p = 0.021). Conclusion(s): Fertility-specific quality of life scores reveals better results regarding the orientation to the treatment environment in the couples with a previous IVF failure, compared to first IVF cycle couples. Treatment failure does not elevate the level of anxiety, while the effect on depression scores changes according to duration of infertility. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Objective: To assess serum levels of 25-hydroxyvitamin D [25(OH)D] in the first trimester and to determine the factors affecting deficiency levels and its association with pregnancy outcomes. Methods: Serum 25(OH)D concentrations were measured at 11-14 weeks’ gestation in 229 singleton pregnancies using liquid chromatography-tandem mass spectrometry. Results: The median serum 25(OH)D concentration was 10.8 ng/mL and 45.9% of women had severe vitamin D deficiency with concentrations of

Introduction. All findings of preeclampsia appear as the clinical consequences of diffuse endothelial dysfunction. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) was recently introduced as a TNF related cytokine in various inflammatory and noninflammatory disorders. sTWEAK was found to be related to endothelial dysfunction in patients with chronic kidney disease. In our study we aimed to compare sTWEAK levels in women with preeclampsia to corresponding levels in a healthy pregnant control group.Materials and Methods. The study was undertaken with 33 patients with preeclampsia and 33 normal pregnant women. The concentration of sTWEAK in serum was calculated with an enzyme linked immunosorbent assay (ELISA) kit.Results. Serum creatinine, uric acid, LDH levels, and uPCR were significantly higher in the patient group compared to the control group. sTWEAK levels were significantly lower in preeclamptic patients (332 ± 144 pg/mL) than in control subjects (412 ± 166 pg/mL) (p=0.04).Discussion. Our study demonstrates that sTWEAK is decreased in patients with preeclampsia compared to healthy pregnant women. There is a need for further studies to identify the role of sTWEAK in the pathogenesis of preeclampsia and to determine whether it can be regarded as a predictor of the development of preeclampsia.

INTRODUCTION: To investigate uterine artery Doppler findings and maternal homocysteine levels in relation with of adverse pregnancy outcomes during the second trimester of pregnancy.METHODS: A prospective case-control study was performed with 185 healthy pregnant women. Uterine artery Doppler velocimetry was performed between 20 and 24 weeks of gestation. Maternal serum homocysteine concentrations were measured. Doppler results and homocysteine levels were used in prediction of adverse pregnancy outcome.RESULTS: According to the uterine artery Doppler findings pregnant women were divided into two groups. The first group composed of women with bilateral diastolic notches (case group, n=85), the second group composed of the women with unilateral notches, and the women with no diastolic notch (control group, n=88) formed the third group. Pregnancy-induced hypertension (p, GİRİŞ ve AMAÇ: İkinci trimesterde uterin arter Doppler bulguları ve maternal serum homosistein düzeyi ile kötü gebelik sonuçları arasındaki ilişkinin araştırılması. YÖNTEM ve GEREÇLER: 185 gebe üzerinde yapılan prospektif olgu-kontrol çalışmasında 20-24. gebelik haftaları arasında uterin arter Doppler incelemesi yapıldı ve serum homosistein düzeyi ölçüldü.BULGULAR: Gebeler uterin arter Doppler bulgularına göre bilateral erken diyastolik çentiklenmesi olanlar olgu grubu (n=97); çentik bulunmayan veya unilateral çentiklenmesi olan olgular kontrol grubu (n=88) olmak üzere iki gruba ayrıldı. Gebeliğe bağlı hipertansiyon (p

… Amer Soc Reprod Med

Amaç: Bu çalışmanın amacı myoma uteri nedeniyle uygulanan abdominal veya laparoskopik myomektomi yönteminin postoperatif komplikasyon ve ameliyat sonrası fertilite üzerine etkisinin karşılaştırılmasıdır.Gereç ve Yöntem: 2003-2007 yılları arasında Süleymaniye Kadın Hastalıkları ve Doğum Hastanesi’nde myomektomi yapılmış toplam 221 hastanın dosyası rektospektif olarak incelendi. Hastalar uygulanan cerrahi yönteme göre 2 gruba ayrıldı. 136 hastaya abdominal myomektomi, 85 hastaya laparoskopik myomektomi uygulanmış olup gruplar birbiriyle karşılaştırıldı.Bulgular: Gruplar arasında yaş, sigara içimi, geçirilmiş batın operasyonu ve geçirilmiş pelvik enfeksiyon öyküsü, postoperatif kan transfüzyon ihtiyacı ve ileus görülme bakımından anlamlı farklılık yoktu (p>0.05). Ortalama parite sayısı, laparoskopik myomektomi grubunda anlamlı olarak fazla idi (p =0.018). Abdominal myomektomi grubunda çıkarılan myom sayısının 4’ten fazla olması (p, Objective: The aim of this study is to compare the postoperative complications of laparoscopic and abdominal myomectomy procedures for the myoma of uterus and their effects on postoperative fertility.Material and Methods: In this study, we retrospectively evaluated 221 cases who were performed myomectomy operation at Suleymaniye Obstetrics and Gynecology Hospital between 2003-2007. All cases were divided into two groups with respect to the surgical procedure performed. 136 patients were in the abdominal myomectomy (AM) group, 85 patients were in the laparoscopic myomectomy group and the groups were compared. Results: There is no significant difference in age, smoking, history of abdominal surgery, pelvic infection, postoperative need for transfusion, and ileus between the groups. The mean number of parity was higher in the laparoscopic myomectomy group. In abdominal myomectomy group, number of cases in which more than 4 myomas were removed (p

Background: Endocan has been shown to be a marker for several cancers and may show degree of malignancy. The aim of this study is to assess serum levels of endocan before and after surgery on low-grade gliomas (LGGs). Methods: Endocan was assayed by commercially available enzyme-linked immunosorbent assay (ELISA) kits in a total of 19 patients and 12 controls. Serial serum samples were obtained before and after surgery (1st day, 1st week, and 1st month of surgery). Control samples were collected from cord blood during cesarean section. The results were compared with control brain tissues. Results: Controls showed significantly lower serum endocan levels compared to before and after surgery (P < 0.05). There is a trend of increase in mean serum levels from before surgery and during the very early period after surgery (during first week); however, in the first month, mean serum levels became lower. Conclusion: Endocan, a vital molecule for angiogenesis, is highly expressed before and after surgery in LGGs, but long-term data is needed. Furthermore, future studies should include high-grade gliomas to discuss whether endocan is associated with recurrence and response to treatment.

We designed a prospective case-control study in order to investigate the lipid profiles, insulin sensitivity, presence of metabolic syndrome (MetS) and the abdominal fat distribution in karyotypically normal women with premature ovarian insufficiency (POI).Anthropometric measurements, FSH, estradiol, total testosterone (T), sex hormone binding globulin (SHBG), free androgen index (FAI), fasting glucose and insulin, homeostatic model for insulin resistance (HOMA-IR), lipid profile, the prevalence of MetS and ultrasonographic abdominal fat measurements were assessed in 56 women with POI and 59 healthy controls at the same age range.Serum levels of T, SHBG and FAI were not significantly different between both groups. Total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were higher in women with POI. There were no differences in glucose, insulin, HOMA-IR, low-density lipoprotein cholesterol (LDL-C), triglyceride levels between the two groups. A significant positive correlation was identified between T and TG and also between FAI and LDL-C; SHBG levels were correlated inversely with FSH, and positively with HDL-C in women with POI. The presence of MetS was significantly higher in women with POI. The subcutaneous, preperitoneal and visceral fat thicknesses were not significantly different between the groups.Early cessation of ovulatory function may associated with higher levels of serum TC and HDL-C, but does not seem to cause differences in abdominal fat distribution in women with POI. POI is associated with higher risk of MetS.

Swyer syndrome is characterised by 46,XY karyotype and a female phenotype with normally developed Mullerian ducts, streak gonads, minimal breast enlargement, elevated gonadotropins, low levels of o...

This study evaluated the clinical outcomes and safety of treating caesarean scar pregnancy (CSP) by means of suction curettage followed when required by Foley tamponade, with or without methotrexate (MTX) therapy preceding the curettage.Twenty-five patients with CSP were identified between August 2008 and April 2012. The first team of doctors treated Group A patients (n = 11) with systemic MTX followed by dilatation and suction curettage whereas the second team of doctors carried out only a suction curettage on women of Group B (n = 14). If uncontrolled vaginal bleeding occurred in either group during or after the operation, a Foley catheter, guided by real time transabdominal ultrasound, was placed in the uterine cavity against the site where the CSP had been implanted.Clinical outcomes in the two groups - including mean estimated blood loss, major complication rate, and hospital length of stay - were comparable. Surgeons used Foley catheter balloons for tamponade in six of the 11 patients in Group A and in seven of the 14 patients in Group B. Treatment was successful in ten of 11 cases in group A and 13 of 14 cases in group B. Group B's mean duration of treatment (2.36 ± 0.49 days) was significantly shorter than that of Group A (14.45 ± 4.96 days; p0.001).Suction curettage, followed when needed by Foley catheter tamponade, is an effective treatment for CSP.